Abstract

165 newly homeless adolescents from Melbourne, Australia and 261 from Los Angeles, United States were surveyed and followed for two years. Most newly homeless adolescents returned home (70% U.S., 47% Australia) for significant amounts of time (39% U.S., 17% Australia more than 12 months) within two years of becoming homeless.

Keywords: homeless, homeless youth, runaways, Australia

A large number of cross-sectional, epidemiological studies have documented the high rates of risky health behaviors and negative outcomes for homeless youth (i.e., runaway/throwaway youth) [1]. Representative cross-sectional data suggest that 1.7 million youth [2], approximately 7.6% of U.S. youth, experience at least one night of homelessness annually [3]. Globally, there is a perception that leaving home leads to chronic homelessness, but there are no longitudinal data to support or dispute this assumption. This study examines the rate and timing of returning home over 24 months among samples of newly homeless youth in Los Angeles, California and Melbourne, Australia.

Methods

Each newly homeless youth was identified by an interviewer conducting a 13-item screening that established whether the youth: 1) was aged 12 to 20 years; 2) had spent at least two consecutive nights away from home (after being ejected or leaving without a guardian’s permission); and 3) had lived away from home for less than six months. Time away rather than number of homeless episodes defined a newly homeless adolescent as determined from conversations with service providers. The sampling procedure varied slightly across countries, reflecting differences in the type, number, and geographical distribution of agencies serving homeless youth and policies in each setting [4]. In California, the probabilities of newly homeless youth presenting in each shelter (n = 17) and street site (n = 13) were assessed and an interviewing rotation plan was designed to yield a representative sample. In Australia, recruitment was based on staff referral from 95 service and homeless service agencies in Melbourne. In Los Angeles, 261 newly homeless youth were recruited (58% female; 23% African American, 43% Latino, and 20% White) and 165 newly homeless youth in Melbourne were recruited (75% female) ranging from 12 to 20 years old (M = 17.3; SD = 1.9). American youth averaged one year younger than the Australians and their parents were more likely to have been high school or college graduates.

The study fulfilled all human subject guidelines and was approved by the appropriate Institutional Review Boards at both the U.S. and Australian research centers. Following informed consent, youth completed 1 to 1 ½ hour interviews at recruitment, between July 2000 and June 2002. These interviews included: homeless experience, sexual behavior, substance use, mental health status, social networks, and relationships. The interviews were repeated at 3, 6, 12, 18, and 24 months, with retention rates ranging from 74% to 86%, with 61% completing all five follow-ups. Youth received $20 to $40 per interview.

Using laptop computers, trained interviewers assessed whether the youth returned to the family home or not; time to when the youth first returned home (evaluated at the 3, 6, 12, 18, and 24 month assessments); and the period of time the youth lived at home in months ranging from 0 to 24 months consecutively. Survival analyses were conducted examining the time to first return home based on city, age, and gender. Time to return home was calculated from the start of the homelessness episode prior to baseline until the first return home in the follow-up period, measured in months.

Results

Newly homeless youth in Los Angeles were significantly more likely to return home than youth in Melbourne (χ2 = 12.8, P < .001, controlling for age and gender) (Fig. 1). Within six months, 30% returned home in Los Angeles, but only 9% returned home in Melbourne. After six months, the rate of returning home was similar across sites (χ2 = 3.7, P > .05). In the follow-up period, 29% of Los Angeles youth and 53% of Melbourne youth did not return home; 31% spent 1 to 11 consecutive months at home in both sites; 23% in Los Angeles and 15% in Melbourne spent between 12 to 23 months at home; and 16% versus 1% spent 24 months at home. Older youth were significantly less likely to return home at both sites (χ2 = 26.3, P < .0001) (Fig. 2). Males and females returned home at similar rates when controlling for site (χ2 = 0.6, P = .43).

Kaplan-Meier survival curve for time to first return home, by age group

Discussion

More newly homeless youth in Los Angeles returned home within 24 months compared to youth in Melbourne. One of the limitations of this study was the slightly different recruitment procedures across sites. Some cross-country differences could have resulted; however, elsewhere we have demonstrated that similar levels of industrialization do not lead to similar experiences for homeless youth [5]. To the contrary, fewer youth entered into homelessness in Australia relative to the United States, probably due to a superior set of social services available. Those youth in Australia, however, who did become homeless were more engaged in risk behaviors [5] and the data demonstrate they were less likely to return home within two years.

Over two years, many youth in each city returned home and remained home for long periods. Typically, cross-sectional data collected from experienced homeless youth paint a picture of newly homeless youth entering into negative developmental pathways, fraught with sexual and drug taking risk behaviors, which often result in chronic homelessness [6]. Although Hammer and colleagues [2] also found high levels of returning home in retrospective cross-sectional data, this is the first longitudinal data to demonstrate that newly homeless youth return to home at high rates and often stay home for long periods.

Street life exposes youth to a wide array of health risks [1] for which families may be an untapped resource of intervention. Previously published results demonstrated that youth in these data were disproportionately engaged in sexual and drug taking risk behaviors, relative to national averages [5]. Interventions for homeless youth have focused on individual risk reduction at agency settings because homeless youth have been viewed as beyond the reach of their families. But our data suggest that family-based interventions, which work with homeless youth and their families, may be viable and underdeveloped alternatives to address adolescent problem behaviors and issues of family conflict and communication, particularly for younger adolescents who are more likely to return home.

Acknowledgments

National Institutes of Mental Health grants #1ROI MH49958-04 and P30MH58107 supported this study.

Footnotes

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